Date of Defense
17-11-2025 6:00 PM
Location
F1-1043
Document Type
Dissertation Defense
Degree Name
Doctor of Philosophy in Mechanical & Aerospace Engineering
College
COE
Department
Mechanical and Aerospace Engineering
First Advisor
Dr. Kassim Abdullah
Keywords
Child occupant, injury, crash analysis, UAE, child restraint system, anthropometry, legislation
Abstract
The United Arab Emirates (UAE) has one of the highest rates of child occupant injuries and fatalities globally. A comprehensive review of the literature revealed very limited research on child occupant injuries and fatalities in the UAE. All but two of the identified studies relied on data from Al Ain-based sources namely - Al Ain Department of Preventive Medicine, Al Ain Hospital, and Tawwam Hospital - and were restricted to that city. Furthermore, most of these studies were conducted nearly 30 years ago with the two most recent ones (conducted over a decade ago) based on crash data that was already ten years old at the time of analysis. To address this significant gap, the first aim of this dissertation was to identify the key risk factors associated with child occupant injuries and fatalities using a recent national dataset to provide recommendations for achieving comprehensive reductions in child occupant injuries and fatalities. A retrospective population-based analyses of UAE national crash data for child occupants aged 17 years or younger at the time of the crash was conducted. The data was obtained from the UAE Ministry of Interior (MOI) for the years 2012-2023. Descriptive statistical analyses were performed to describe the demographic, crash, environmental, temporal, and outcome variables. Univariate ordinal logistic regression analyses were conducted to determine the factors that were significantly associated with child occupant injury severity. The variables that were found to be significantly associated with child occupant injury severity were subsequently included in the multivariable model to adjust for potential confounding effects. The results show that girls were less likely to sustain injuries than boys (OR: 0.720, CI:-0.522, -0.137). Similarly, crashes due to tailgating (OR: 0.405, CI:-1.243, -0.562) and sudden deviation (OR: 0.713, CI:-0.596, -0.081) had lower injury risk compared to the “others” (distracted driving, negligence/inattention, impaired driving, non-compliance to traffic signals, right of way violation, etc.) crash causes. On the other hand, crashes due to speeding without considering road conditions (OR: 1.729, CI:0.211, 0.883) had higher odds of injuries for child occupants. Child occupants seated in the driver seating position (OR: 1.826, CI:0.350, 0.854) and front seat (OR: 1.784, CI:0.368, 0.790) were more likely to sustain injuries compared to those seated in the rear seat. Child occupant crashes that occurred at commercial areas (OR: 0.605, CI:-0.806, -0.199) had lower odds of injury compared to the “others” (government area, tunnel/bridge, school, sandy area, petrol station, etc.) crash locations. Conversely, highway crashes (OR: 1.301, CI:0.024, 0.503) were associated with increased injury risk for child occupants. Rollover crashes (OR: 2.718, CI:0.193, 0.862) and fixed-object collisions (OR: 1.465, CI:0.031, 0.732) were associated with higher odds of injury compared to the “others” (rotational collision, motionless collision, moving-object collision, consecutive collision, fall crash, etc.) crash types. Compared to crashes that occurred in fall, crashes that occurred in summer months were associated with higher injury risk for child occupants (OR: 1.307, CI:0.010, 0.526). These findings should be employed to develop strategies to improve child occupant safety in the UAE. Child passenger legislation (CPL) has proven to be effective in ensuring child restraint system (CRS) use, thereby positively enhancing the safety outcomes of traffic crashes involving children. Road safety legislation mandating the use of child safety seats (CSS) and seatbelts was enacted in July 2017 by the UAE government. This legislation requires the use of a CSS for children up to 4 years of age and seatbelt use for all other vehicle occupants. The second aim of this dissertation was to evaluate the impact of UAE’s CPL on reducing the counts and rates of injuries and fatalities per child population among child occupants aged 0–14 years from 2012 to 2023, controlling for several confounders. Time-series Poisson regression analyses were used compared to the incidence of these outcomes between the pre and post-legislation periods. The results indicate that the legislation significantly reduced the counts of minor injuries by 48% (IRR: 0.52, CI: 0.39-0.69, p< 0.001), severe injuries by 55% (IRR: 0.45, CI: 0.21-0.96, p=0.044), and fatal injuries by 70% (IRR: 0.30, CI: 0.12-0.67, p=0.005) for children aged 0-4 years as well as the counts of moderate injuries by 33% (IRR: 0.67, CI: 0.51-0.87, p=0.003) for children aged 10-14 years. No significant reductions were observed in injury and fatality rates among children aged 0–14 years. The legislation was also more effective in reducing injury and fatality risk among girls and on roads with more than two lanes. These findings highlight that the legislation's effectiveness varies across both modifiable and non-modifiable risk factors. To sustain and enhance the gains of the CPL, targeted interventions, continuous public education campaigns, and strict policy enforcement are recommended. CRS have been demonstrated to significantly reduce the risk of injuries and fatalities for child occupants. However, several studies conducted before the enactment of the CPL have reported low rates of CRS use in the UAE. Therefore, the third aim of this dissertation was to assess the prevalence of CRS use post CPL in the UAE and to identify the factors associated with CRS use, appropriate use, misuse, and best practice (BP) use among children. The social ecological model (SEM) was used to examine the individual, interpersonal, community, and societal factors. Parents and carers of children younger than 13 years completed a self-reported questionnaire (n = 409). Backward logistic regression was used to determine the factors associated with CRS use, appropriate use, misuse, and BP use. Results of the study indicate that only 44.3% of parents always restrained their child while travelling in a vehicle, 49% restrained their child appropriately, 21.4% had no CRS misuse while restraining their child, and 9% achieved BP CRS use. Individual level factors were mostly the predictors of CRS use, appropriate use, misuse, and BP use. Parental seatbelt use was associated with CRS use while non-use was associated with CRS misuse. Parental perception that their child is happy to be restrained in a CRS was associated with both CRS use and BP use. Frequent parental removal of their child’s CRS from the vehicle was associated with CRS misuse while infrequent removal was associated with BP use. Parental self-blame if their child was to sustain serious injuries while travelling unrestrained in a vehicle was associated with CRS appropriate use while the lack of self-blame is associated with CRS use. Strict parenting style and recommendation to use CRS were associated with CRS use while parental relationship with the child was associated with appropriate CRS use at the interpersonal level. At the community level, CRS use was associated with ethnicity. Multilevel factors including children aged less than 1 year and using a rear-facing CRS were associated with appropriate CRS use. The findings of this study should be translated into targeted interventions to promote CRS use, appropriate use, and BP use as well as reducing CRS misuse at the different levels of the SEM.
Child occupants can be legally restrained by adult seatbelts from the age of 5 years in the UAE. However, the BP recommendation for achieving appropriate seatbelt fit for children is a minimum height of 148 cm, weight of 37 kg, and seated height of 74 cm. The fourth aim of this dissertation was to evaluate whether the current UAE CPL aligns with the physical characteristics of the local child population. Representative anthropometric data was collected from 627 children aged 5-12 years old in the UAE. Key measurements included height, weight, and seated height which are essential for assessing seatbelt fit. Descriptive statistical analysis was performed to obtain the frequencies and percentages for these measurements. The values for height, seated height, and weight were calculated for each child occupant age. To compare the anthropometric data of children in the UAE against the BP recommendations for protecting child occupants in vehicles, the proportions of child occupants smaller than 148 cm in height, smaller than 74 cm in seated height, and lighter than 37 kg in weight were calculated for the children. Results of the study shows that 100% of children aged 5–7 years, 99% aged 8–9 years, 87% aged 10 years, 76% aged 11 years, and 59% aged 12 years do not meet the combined requirement of 148 cm in height, 74 cm in seated height, and 37 kg in weight for achieving proper adult seatbelt fit. This finding should serve as justification for enhancements to the CPL in the UAE to ensure that child occupants are using an appropriate restraint for their age, shape, and size and therefore will be appropriately protected by the restraint in the event of a motor vehicle crash. Ultimately, the findings
Included in
CHILD OCCUPANT SAFETY IN THE UNITED ARAB EMIRATES: CRASH, INJURY, AND ANTHROPOMETRIC ANALYSIS
F1-1043
The United Arab Emirates (UAE) has one of the highest rates of child occupant injuries and fatalities globally. A comprehensive review of the literature revealed very limited research on child occupant injuries and fatalities in the UAE. All but two of the identified studies relied on data from Al Ain-based sources namely - Al Ain Department of Preventive Medicine, Al Ain Hospital, and Tawwam Hospital - and were restricted to that city. Furthermore, most of these studies were conducted nearly 30 years ago with the two most recent ones (conducted over a decade ago) based on crash data that was already ten years old at the time of analysis. To address this significant gap, the first aim of this dissertation was to identify the key risk factors associated with child occupant injuries and fatalities using a recent national dataset to provide recommendations for achieving comprehensive reductions in child occupant injuries and fatalities. A retrospective population-based analyses of UAE national crash data for child occupants aged 17 years or younger at the time of the crash was conducted. The data was obtained from the UAE Ministry of Interior (MOI) for the years 2012-2023. Descriptive statistical analyses were performed to describe the demographic, crash, environmental, temporal, and outcome variables. Univariate ordinal logistic regression analyses were conducted to determine the factors that were significantly associated with child occupant injury severity. The variables that were found to be significantly associated with child occupant injury severity were subsequently included in the multivariable model to adjust for potential confounding effects. The results show that girls were less likely to sustain injuries than boys (OR: 0.720, CI:-0.522, -0.137). Similarly, crashes due to tailgating (OR: 0.405, CI:-1.243, -0.562) and sudden deviation (OR: 0.713, CI:-0.596, -0.081) had lower injury risk compared to the “others” (distracted driving, negligence/inattention, impaired driving, non-compliance to traffic signals, right of way violation, etc.) crash causes. On the other hand, crashes due to speeding without considering road conditions (OR: 1.729, CI:0.211, 0.883) had higher odds of injuries for child occupants. Child occupants seated in the driver seating position (OR: 1.826, CI:0.350, 0.854) and front seat (OR: 1.784, CI:0.368, 0.790) were more likely to sustain injuries compared to those seated in the rear seat. Child occupant crashes that occurred at commercial areas (OR: 0.605, CI:-0.806, -0.199) had lower odds of injury compared to the “others” (government area, tunnel/bridge, school, sandy area, petrol station, etc.) crash locations. Conversely, highway crashes (OR: 1.301, CI:0.024, 0.503) were associated with increased injury risk for child occupants. Rollover crashes (OR: 2.718, CI:0.193, 0.862) and fixed-object collisions (OR: 1.465, CI:0.031, 0.732) were associated with higher odds of injury compared to the “others” (rotational collision, motionless collision, moving-object collision, consecutive collision, fall crash, etc.) crash types. Compared to crashes that occurred in fall, crashes that occurred in summer months were associated with higher injury risk for child occupants (OR: 1.307, CI:0.010, 0.526). These findings should be employed to develop strategies to improve child occupant safety in the UAE. Child passenger legislation (CPL) has proven to be effective in ensuring child restraint system (CRS) use, thereby positively enhancing the safety outcomes of traffic crashes involving children. Road safety legislation mandating the use of child safety seats (CSS) and seatbelts was enacted in July 2017 by the UAE government. This legislation requires the use of a CSS for children up to 4 years of age and seatbelt use for all other vehicle occupants. The second aim of this dissertation was to evaluate the impact of UAE’s CPL on reducing the counts and rates of injuries and fatalities per child population among child occupants aged 0–14 years from 2012 to 2023, controlling for several confounders. Time-series Poisson regression analyses were used compared to the incidence of these outcomes between the pre and post-legislation periods. The results indicate that the legislation significantly reduced the counts of minor injuries by 48% (IRR: 0.52, CI: 0.39-0.69, p< 0.001), severe injuries by 55% (IRR: 0.45, CI: 0.21-0.96, p=0.044), and fatal injuries by 70% (IRR: 0.30, CI: 0.12-0.67, p=0.005) for children aged 0-4 years as well as the counts of moderate injuries by 33% (IRR: 0.67, CI: 0.51-0.87, p=0.003) for children aged 10-14 years. No significant reductions were observed in injury and fatality rates among children aged 0–14 years. The legislation was also more effective in reducing injury and fatality risk among girls and on roads with more than two lanes. These findings highlight that the legislation's effectiveness varies across both modifiable and non-modifiable risk factors. To sustain and enhance the gains of the CPL, targeted interventions, continuous public education campaigns, and strict policy enforcement are recommended. CRS have been demonstrated to significantly reduce the risk of injuries and fatalities for child occupants. However, several studies conducted before the enactment of the CPL have reported low rates of CRS use in the UAE. Therefore, the third aim of this dissertation was to assess the prevalence of CRS use post CPL in the UAE and to identify the factors associated with CRS use, appropriate use, misuse, and best practice (BP) use among children. The social ecological model (SEM) was used to examine the individual, interpersonal, community, and societal factors. Parents and carers of children younger than 13 years completed a self-reported questionnaire (n = 409). Backward logistic regression was used to determine the factors associated with CRS use, appropriate use, misuse, and BP use. Results of the study indicate that only 44.3% of parents always restrained their child while travelling in a vehicle, 49% restrained their child appropriately, 21.4% had no CRS misuse while restraining their child, and 9% achieved BP CRS use. Individual level factors were mostly the predictors of CRS use, appropriate use, misuse, and BP use. Parental seatbelt use was associated with CRS use while non-use was associated with CRS misuse. Parental perception that their child is happy to be restrained in a CRS was associated with both CRS use and BP use. Frequent parental removal of their child’s CRS from the vehicle was associated with CRS misuse while infrequent removal was associated with BP use. Parental self-blame if their child was to sustain serious injuries while travelling unrestrained in a vehicle was associated with CRS appropriate use while the lack of self-blame is associated with CRS use. Strict parenting style and recommendation to use CRS were associated with CRS use while parental relationship with the child was associated with appropriate CRS use at the interpersonal level. At the community level, CRS use was associated with ethnicity. Multilevel factors including children aged less than 1 year and using a rear-facing CRS were associated with appropriate CRS use. The findings of this study should be translated into targeted interventions to promote CRS use, appropriate use, and BP use as well as reducing CRS misuse at the different levels of the SEM.
Child occupants can be legally restrained by adult seatbelts from the age of 5 years in the UAE. However, the BP recommendation for achieving appropriate seatbelt fit for children is a minimum height of 148 cm, weight of 37 kg, and seated height of 74 cm. The fourth aim of this dissertation was to evaluate whether the current UAE CPL aligns with the physical characteristics of the local child population. Representative anthropometric data was collected from 627 children aged 5-12 years old in the UAE. Key measurements included height, weight, and seated height which are essential for assessing seatbelt fit. Descriptive statistical analysis was performed to obtain the frequencies and percentages for these measurements. The values for height, seated height, and weight were calculated for each child occupant age. To compare the anthropometric data of children in the UAE against the BP recommendations for protecting child occupants in vehicles, the proportions of child occupants smaller than 148 cm in height, smaller than 74 cm in seated height, and lighter than 37 kg in weight were calculated for the children. Results of the study shows that 100% of children aged 5–7 years, 99% aged 8–9 years, 87% aged 10 years, 76% aged 11 years, and 59% aged 12 years do not meet the combined requirement of 148 cm in height, 74 cm in seated height, and 37 kg in weight for achieving proper adult seatbelt fit. This finding should serve as justification for enhancements to the CPL in the UAE to ensure that child occupants are using an appropriate restraint for their age, shape, and size and therefore will be appropriately protected by the restraint in the event of a motor vehicle crash. Ultimately, the findings